Abstract
Introduction
Myxofibrosarcoma is described by WHO as comprising of a spectrum of malignant fibroblastic lesions with variably myxoid stoma, pleomorphism and with a distinctively curvilinear vascular pattern. They are reported to be one of the commonest sarcomas of elderly patients. It has previously been reported to have a high rate of locally recurrent disease (50-60%). The aim of the study was to investigate the ROH series of tumours to determine prognostic factors for survival and local recurrence.
Methods
Patients were identified from the ROH database who had been treated with a new presentation of myxofibrosarcoma. The size, grade and depth of the tumour at presentation was noted. Those patients who had suffered local or distal disease relapse or died were highlighted. Analysis was undertaken by Kaplan Meier survival curves for univariate and cox regression for multivariate analysis.
Results
90 patients were indentified who had undergone surgery for myxofibrosarcoma. The mean age was 65 years (range 23-93 years) with an equal male to female ratio. They presented deep to fascia in 49 cases (54%) and were most commonly located in the lower extremity in 53 cases (59%) with 32 cases being in the thigh. The maximum dimension at presentation was 9cm (range 0.3 to 42cm). The grade at presentation was high in 41 cases, intermediate in 35 cases and low in 14 cases. The risk of local recurrence was 25% at 5 years and was independent of margin or size. Overall survival was 59% at 5 years with high grade tumours being the only independent prognostic factor for survival at 5 years (HR=10).
Conclusion
Myxofibrosarcoma is a tumour that often presents superficially with a high rate of local recurrence. Other studies (Gronchi 2010) have suggested that size and surgical margins were prognostic but this was not seen in our study.
